@article{ref1,
title="Hurricane Florence and suicide mortality in North Carolina: a controlled interrupted time-series analysis",
journal="Injury prevention",
year="2022",
author="Miller, Vanessa Eve and Pence, Brian W. and Fitch, Kate Vinita and Swilley-Martinez, Monica and Kavee, Andrew L. and Dorris, Samantha and Cooper, Toska and Keil, Alexander P. and Gaynes, Bradley N. and Carey, Timothy S. and Goldston, David and Ranapurwala, Shabbar",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Natural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in September 2018, may have impacted suicide deaths in North Carolina (NC). <br><br>METHODS: We used publicly available NC death records data to estimate associations between Hurricane Florence and monthly suicide death rates using a controlled, interrupted time series analysis. Hurricane exposure was determined by using county-level support designations from the Federal Emergency Management Agency. We examined effect modification by sex, age group, and race/ethnicity. <br><br>RESULTS: 8363 suicide deaths occurred between January 2014 and December 2019. The overall suicide death rate in NC between 2014 and 2019 was 15.53 per 100 000 person-years (95% CI 15.20 to 15.87). Post-Hurricane, there was a small, immediate increase in the suicide death rate among exposed counties (0.89/100 000 PY; 95% CI -2.69 to 4.48). Comparing exposed and unexposed counties, there was no sustained post-Hurricane Florence change in suicide death rate trends (0.02/100 000 PY per month; 95% CI -0.33 to 0.38). Relative to 2018, NC experienced a statewide decline in suicides in 2019. An immediate increase in suicide deaths in Hurricane-affected counties versus Hurricane-unaffected counties was observed among women, people under age 65 and non-Hispanic black individuals, but there was no sustained change in the months after Hurricane Florence. <br><br>CONCLUSIONS: Although results did not indicate a strong post-Hurricane Florence impact on suicide rates, subgroup analysis suggests differential impacts of Hurricane Florence on several groups, warranting future follow-up.<p /> <p>Language: en</p>",
language="en",
issn="1353-8047",
doi="10.1136/ip-2022-044709",
url="http://dx.doi.org/10.1136/ip-2022-044709"
}